African countries have a very low density health workforce, compounded by poor skill mix and inadequate investment.1 Yet trained healthcare staff continue to migrate from Africa to more developed countries. The World Health Organization has estimated that, to meet the ambitious targets of the millennium development goals, African health services will need to train and retain an extra one million health workers by 2010.2

It is too simplistic and misleading to define or try to resolve the crisis in human resources for health in Africa by looking only at overall numbers and density of workers, not least because these vary from country to country.34 Furthermore, the poor performance of health services in African countries is often compounded by shortages of drugs and other essential supplies, broken equipment, and poor …